84

 

 

Second Session, 50th General Assembly

3 Charles III, 2024

BILL 84

AN ACT TO AMEND THE REGISTERED NURSES ACT, 2008

Received and Read the First Time................................................................

Second Reading............................................................................................

Committee.....................................................................................................

Third Reading...............................................................................................

Royal Assent.................................................................................................

HONOURABLE JOHN HOGAN, KC

Minister of Health and Community Services and Attorney General

Ordered to be printed by the Honourable House of Assembly

 

EXPLANATORY NOTES

This Bill would amend the Registered Nurses Act, 2008 to

ˇ         amend definitions, add new definitions and remove a definition that is no longer required;

ˇ         update terminology used in the Act;

ˇ         remove the authority to appoint persons as honorary members of the College of Registered Nurses of Newfoundland and Labrador;

ˇ         allow the registration of registered psychiatric nurses; and

ˇ         incorporate gender-neutral language.

A BILL

AN ACT TO AMEND THE REGISTERED NURSES ACT, 2008

Analysis

        1.   S.2 Amdt.
Definitions

        2.   S.3 Amdt.
Corporation

        3.   S.6 Amdt.
Composition of the council

        4.   S.8 Amdt.
Council officers

        5.   S.10 Amdt.
By-laws

        6.   S.11 Amdt.
Regulations

        7.   S.14 Amdt.
Qualification for registration and licensing

        8.   S.15 Amdt.
Requirement of council to keep registers

        9.   S.16 R&S
Requirements to practise

      10.   S.17 R&S
Prohibition

      11.   S.18 Amdt.
Definitions

      12.   S.19 Amdt.
Committees

      13.   S.20 R&S
Duty to report

      14.   S.21 Amdt.
Allegation

      15.   S.22 Amdt.
Effect of filing allegation

      16.   S.23 Amdt.
Complaints authorization committee

      17.   S.24 Amdt.
Adjudication tribunal

      18.   S.25 Amdt.
Hearing

      19.   S.27 Amdt.
Guilty plea by respondent

      20.   S.28 Amdt.
Powers of adjudication tribunal

      21.   S.30 Amdt.
De-registration and suspension

      22.   S.32 Amdt.
Reinstatement and readmission

      23.   S.35.1 Amdt.
Quality assurance committee

      24.   S.35.2 R&S
Registrant shall comply

      25.   S.35.3 Amdt.
Conduct of review

      26.   S.35.4 Amdt.
Costs

      27.   S.35.5 Amdt.
Termination of review

      28.   S.36 R&S
Other care givers

      29.   S.39.1 Added
Conflicting legislation

      30.   S.40 Amdt.
Offence

      31.   SNL2018 cC-12.3 Amdt.

      32.   SNL2011 cG-7.1 Amdt.

      33.   SNL1995 cP-37.1 Amdt.

      34.   SNL2005 cL-12.1 Amdt.

      35.   SNL2006 cP-12.01 Amdt.

      36.   SNL2024 cP-12.3 Amdt.

      37.   SNL2009 cV-6.01 Amdt.

      38.   NLR 24/19 Amdt.

      39.   NLR 45/15 Amdt.

      40.   NLR 56/19 Amdt.

      41.   NLR 83/23 Amdt.

      42.   NLR 53/18 Amdt.

      43.   NLR 114/96 Amdt.

      44.   NLR 15/01 Amdt.

      45.   NLR 121/18 Amdt.

      46.   Commencement

Be it enacted by the Lieutenant-Governor and House of Assembly in Legislative Session convened, as follows:

SNL2008 cR-9.1
as amended

        1. (1) Paragraph 2(a) of the Registered Nurses Act, 2008 is repealed. 

             (2)  Section 2 of the Act is amended by adding immediately after paragraph (d) the following:

         (d.1)  "licence" means, unless the context indicates otherwise, a registered nurse licence, registered psychiatric nurse licence or nurse practitioner licence;

             (3)  Paragraph 2(f) of the Act is repealed and the following substituted:

             (f)  "nurse practitioner" means, unless the context indicates otherwise, a registered nurse who holds a nurse practitioner licence;

             (4)  Section 2 of the Act is amended by adding immediately after paragraph (f) the following: 

          (f.1)  "nurse practitioner licence" means a licence issued under subsection 14(3) to engage in the practice of nursing;

             (5)  Paragraph 2(g) of the Act is repealed and the following substituted:

             (g)  "practice of nursing" means the use of nursing knowledge, theory and skill in

                      (i)  the promotion, maintenance and restoration of health, and

                     (ii)  the prevention, treatment and palliation of illness and injury primarily by

                            (A)  assessing health status,

                            (B)  planning, implementing and evaluating interventions, and

                            (C)  coordinating health services;

             (6)  Section 2 of the Act is amended by adding immediately after paragraph (g) the following:

          (g.1)  "practice of psychiatric nursing" means the use of psychiatric nursing knowledge, theory and skill in

                      (i)  the promotion, maintenance and restoration of health with a focus on psychosocial, mental or emotional health, and

                     (ii)  the prevention, treatment and palliation of illness and injury, with a focus on psychosocial, mental, or emotional disorders and conditions or comorbid physiological conditions, primarily by

                            (A)  assessing health status,

                            (B)  planning, implementing and evaluating interventions, and

                            (C)  coordinating health services;

             (7)  Paragraph 2(h) of the Act is repealed and the following substituted:

             (h)  "register" means, unless the context indicates otherwise, a register referred to in section 15;

             (8)  Paragraph 2(i) of the Act is repealed and the following substituted:

              (i)  "registered nurse" means, unless the context indicates otherwise, a person who is registered under subsection 14(1) and holds a registered nurse licence;

             (9)  Section 2 of the Act is amended by adding immediately after paragraph (i) the following:

           (i.1)  "registered nurse licence" means a licence issued under subsection 14(2) to engage in the practice of nursing;

           (i.2)  "registered psychiatric nurse" means, unless the context indicates otherwise, a person who is registered under subsection 14(1) and holds a registered psychiatric nurse licence;

           (i.3)  "registered psychiatric nurse licence" means a licence issued under subsection 14(5) to engage in the practice of psychiatric nursing;

           (i.4)  "registrant" means a registered nurse, registered psychiatric nurse or nurse practitioner;

 

        2. Subsection 3(3) of the Act is repealed.

 

        3. Subsection 6(1) of the Act is amended by deleting the words "registered nurses" wherever they appear and substituting the word "registrants".

 

        4. Subsection 8(4) of the Act is amended by deleting the words "registered nurse" and substituting the word "registrant".

 

        5. (1) Paragraph 10(1)(d) of the Act is repealed.

             (2)  Paragraph 10(1)(j) of the Act is amended by deleting the words "registered nurse" and substituting the word "registrant".

             (3)  Paragraph 10(1)(k) of the Act is amended by adding immediately after the word "nursing" the words "and the practice of psychiatric nursing".

 

        6. (1) Subsection 11(1) of the Act is amended by deleting the words "registered nurses" wherever they appear and substituting the word "registrants".

             (2)  Paragraph 11(1)(f) of the Act is repealed.

 

        7. (1) Subsections 14(2) and (3) of the Act are repealed and the following substituted:

             (2)  A person who

             (a)  is registered under subsection (1);

             (b)  has met all requirements for the issuance or renewal of a registered nurse licence set out in this Act and the regulations;

             (c)  has paid the required fees; and

             (d)  whose registration or licence to practise nursing in another jurisdiction is not under review, suspended or revoked in the other jurisdiction

is entitled to a registered nurse licence.

             (3)  A registered nurse who

             (a)  has successfully completed a course of study approved by the council; or

             (b)  in the opinion of the council has sufficient knowledge and skills as prescribed by the regulations to practise as a nurse practitioner

is entitled to a nurse practitioner licence.

             (2)  Section 14 of the Act is amended by adding immediately after subsection (4) the following:

             (5)  A person who

             (a)  is registered under subsection (1);

             (b)  has met all requirements for the issuance or renewal of a registered psychiatric nurse licence set out in this Act and the regulations;

             (c)  has paid the required fees; and

             (d)  whose registration or licence to practise psychiatric nursing in another jurisdiction is not under review, suspended or revoked in the other jurisdiction

is entitled to a registered psychiatric nurse licence.

 

        8. Subsection 15(1) of the Act is repealed and the following substituted:

Requirement of council to keep registers

      15. (1) The council shall keep

             (a)  a historical register in which shall be entered the names of persons who have been registered under subsection 14(1) together with other information that the council may require; and

             (b)  an annual register in which shall be entered the names of all persons who hold a licence.  

 

        9. Section 16 of the Act is repealed and the following substituted:

Requirements to practise

      16. Except as provided in this Act, a person shall not practise as a registered nurse, registered psychiatric nurse or nurse practitioner, or represent to be a registered nurse, registered psychiatric nurse or nurse practitioner unless that person is registered and holds a licence.

 

      10. Section 17 of the Act is repealed and the following substituted:

Prohibition

      17. (1) A person who is not a registrant shall not take or use the titles "Registered Nurse", "Registered Psychiatric Nurse" or "Nurse Practitioner" or the initials "RN", "RPN" or "NP", either alone or in combination with other words, letters or description implying that the person is

             (a)  registered and licensed under this Act;

             (b)  entitled to be registered and licensed under this Act; or

             (c)  recognized by law as a registered nurse, registered psychiatric nurse or nurse practitioner.  

             (2)  A person who contravenes this section is guilty of an offence and liable on summary conviction to a fine not exceeding $3,000 for each offence and in default of payment to imprisonment for a period not exceeding one month.

 

      11. (1) Subparagraph 18(c)(iii) of the Act is amended by deleting the words "registered nurse" and substituting the word "registrant".

             (2)  Subparagraph 18(c)(iv) of the Act is amended by adding immediately after the word "nursing" the words "or the practice of psychiatric nursing".

             (3)  Paragraph 18(g) of the Act is repealed and the following substituted:

             (g)  "respondent" means a registrant or a former registrant against whom an allegation is made.

 

      12. (1) Subsection 19(5) of the Act is amended by deleting the words "registered nurses" wherever they appear and substituting the word "registrants".

             (2)  Subsection 19(7) of the Act is repealed and the following substituted:

             (7)  Where the term of office of a member of the disciplinary panel expires, the member continues to be a member of the disciplinary panel until reappointed or replaced.

 

      13. Section 20 of the Act is repealed and the following substituted:

Duty to report

      20. (1) A registrant who has knowledge, from direct observation or objective evidence, of conduct deserving of sanction of another registrant shall report the known facts to the Director of Professional Conduct Review.

             (2)  A person or a corporation, partnership or association that terminates or imposes restrictions on the employment of a registrant based on direct knowledge of the registrant's conduct deserving of sanction shall report the known facts to the Director of Professional Conduct Review.

             (3)  An action shall not be brought against a registrant, person, corporation, partnership or association or its directors or officers for the sole reason that the registrant, person, corporation, partnership or association complied with this section.

 

      14. (1) Subsection 21(1) of the Act is amended by deleting the words "his or her" and substituting the words "the complainant's".

             (2)  Subsection 21(2) of the Act is amended by deleting the words "his or her" and substituting the words "the Director of Professional Conduct Review's".

             (3)  Subsection 21(3) of the Act is amended by

             (a)  deleting the words "registered nurse" wherever they appear and substituting the word "registrant"; and

             (b)  deleting the words "registered nurses" and substituting the word "registrants".

 

      15. Subsection 22(2) of the Act is amended by deleting the words "he or she" and substituting the words "the Director of Professional Conduct Review".

 

      16. (1) Subparagraph 23(4)(a)(i) of the Act is amended by deleting the words "he or she" and substituting the words "that the person".

             (2)  Subsection 23(5) of the Act is repealed and the following substituted:

             (5)  An action for damages does not lie against a registrant, or another person to whom a request is made, solely because the registrant or other person provides information requested under subsection (4).

 

      17. Section 24 of the Act is amended by deleting the words "registered nurses" wherever they appear and substituting the word "registrants".

 

      18. Subsection 25(2) of the Act is amended by deleting the words "his or her".

 

      19. Subsection 27(2) of the Act is amended by deleting the words "his or her" wherever they appear and substituting the words "the respondent's".

 

      20. Subsection 28(3) of the Act is amended by deleting the words "his or her" wherever they appear and substituting the words "the respondent's".

 

      21. Section 30 of the Act is amended by

             (a)  deleting the words "his or her" wherever they appear and substituting the words "the respondent's"; and

             (b)  deleting the words "registered nurse to practise nursing" wherever they appear and substituting the word "registrant".

 

      22. Paragraph 32(1)(b) of the Act is amended by deleting the words "his or her" and substituting the words "the respondent's".

 

      23. (1) Subsection 35.1(1) of the Act is amended by deleting the words "registered nurses" and substituting the word "registrants".

             (2)  Subsection 35.1(2) of the Act is repealed and the following substituted:

             (2)  The committee may appoint registrants or persons registered as registered nurses, registered psychiatric nurses or nurse practitioners in another province or territory of Canada, to act as assessors or to assist the committee to perform its duties and exercise its powers under this Act.

 

      24. Section 35.2 of the Act is repealed and the following substituted:

Registrant shall comply

   35.2 A registrant shall comply with a request or a directive of the committee, or a person appointed to act on behalf of the committee, in connection with the conduct of a quality assurance review with respect to the registrant or the registrant's practice by the committee.

 

      25. (1) Subsection 35.3(1) of the Act is amended by deleting the words "registered nurse or his or her" and substituting the word "registrant or the registrant's".

             (2)  Subsection 35.3(2) of the Act is repealed and the following substituted:

             (2)  In connection with a quality assurance review, the quality assurance committee may

             (a)  require a registrant, or another person who has information pertaining to or possession of records that relate to the registrant's practice, to provide information, including patient records, for inspection or review and to permit them to be copied by the committee or a person appointed by the committee for the purpose;

             (b)  order a registrant to undergo an examination, evaluation, assessment or review of the registrant's professional practices or capacity or fitness to practise, to the extent and under the circumstances required by the committee;

             (c)  engage in periodic or random reviews or audits of a registrant's performance including the consequential review of patient records; and

             (d)  order a registrant to

                      (i)  obtain counselling, including substance abuse counselling, until the registrant can demonstrate to the committee, or another body or a person designated by the committee, that a condition related to the counselling has been overcome,

                     (ii)  obtain medical treatment and authorize a person participating in the provision of that treatment to report on it to the committee,

                    (iii)  complete a course of studies or an educational or training program,

                    (iv)  restrict the registrant's practice,

                     (v)  obtain supervised clinical experience as directed by the committee and to the satisfaction of the committee,

                    (vi)  continue the registrant's practice under conditions the committee may specify, or

                   (vii)  report on the registrant's compliance with an order of the committee and authorize a person to report to the committee on whether the registrant is complying with an order.

             (3)  Subsection 35.3(3) of the Act is amended by deleting the words "registered nurse" wherever they appear and substituting the word "registrant".

             (4)  Subsection 35.3(4) of the Act is amended by deleting the words "registered nurse" and substituting the word "registrant".

             (5)  Subsection 35.3(5) of the Act is repealed and the following substituted:

             (5)  An action for damages does not lie against a registrant, or another person to whom a request is made, solely because the registrant or other person provides information requested under paragraph (2)(a).

             (6)  Subsection 35.3(6) of the Act is amended by deleting the words "registered nurse" and substituting the word "registrant".

 

      26. Section 35.4 of the Act is amended by deleting the words "registered nurse" wherever they appear and substituting the word "registrant".

 

      27. Subsection 35.5(1) of the Act is amended by deleting the words "registered nurse" wherever they appear and substituting the word "registrant".

 

      28. Section 36 of the Act is repealed and the following substituted:

Other care givers

      36. Notwithstanding any other provision of this Act, a legally qualified registered nurse, registered psychiatric nurse or nurse practitioner from another jurisdiction, who is engaged to provide education or consultative services in the province or to accompany and provide care for a person who is temporarily in the province, is permitted to provide those services during the period of the engagement where

             (a)  the period of the engagement does not exceed 28 days; and

             (b)  the registered nurse, registered psychiatric nurse or nurse practitioner does not represent to be a registrant.

 

      29. The Act is amended by adding immediately after section 39 the following:

Conflicting legislation

   39.1 Nothing in this Act affects or applies to the practice of nursing or the practice of psychiatric nursing permitted to be carried out by a person under another statute of the province.

 

      30. Section 40 of the Act is amended by deleting the words "an annual".

SNL2018 cC-12.3 Amdt.

      31. Paragraph 2(1)(bb) of the Children, Youth and Families Act is amended by deleting the word "nurse" and substituting the words "registered nurse, registered psychiatric nurse".

SNL2011 cG-7.1 Amdt.

      32. Subparagraph 2(b)(ii) of the Gunshot and Stab Wound Reporting Act is amended by deleting the words "registered nurse" and substituting the words "registered nurse or nurse practitioner".

SNL1995 cP-37.1 Amdt.

      33. Paragraph 2(g) of the Health and Community Services Act is repealed and the following substituted:

             (g)  "nurse" means a licensed practical nurse as defined in the Licensed Practical Nurses Act, 2005 or a registered nurse, registered psychiatric nurse or nurse practitioner as defined in the Registered Nurses Act, 2008".

SNL2005 cL-12.1 Amdt.

      34. (1) Section 2 of the Licensed Practical Nurses Act, 2005 is amended by adding immediately after paragraph (d) the following:

         (d.1)  "nurse practitioner" means a nurse practitioner as defined in the Registered Nurses Act, 2008;

             (2)  Paragraph 2(f) of the Act is repealed and the following substituted:

             (f)  "registered nurse" means a registered nurse as defined in the Registered Nurses Act, 2008;

             (3)  Section 2 of the Act is amended by deleting the word "and" at the end of paragraph (f) and adding immediately after paragraph (f) the following:

          (f.1)  "registered psychiatric nurse" means a registered psychiatric nurse as defined in the Registered Nurses Act, 2008; and

             (4)  Paragraph 29.1(2)(b) of the Act is amended by deleting the words "registered nurse or as a nurse practitioner" and substituting the words "registered nurse, registered psychiatric nurse or nurse practitioner".

             (5)  Paragraph 35(c) of the Act is amended by deleting the words "registered nurse" and substituting the words "registered nurse, registered psychiatric nurse, nurse practitioner".

             (6)  Paragraph 35(d) of the Act is amended by deleting the words "registered nurse" and substituting the words "registered nurse, registered psychiatric nurse or nurse practitioner".

SNL2006 cP-12.01 Amdt.

      35. Paragraph 2(p) of the Pharmaceutical Services Act is amended by deleting the word "and" at the end of subparagraph (vii), deleting the semi-colon at the end of subparagraph (viii) and substituting a comma and by adding immediately after subparagraph (viii) the following:

                    (ix)  a registered psychiatric nurse licensed under the Registered Nurses Act, 2008; and

SNL2024 cP-12.3 Amdt.

      36. (1) Subsection 3(1) of the Pharmacy Act, 2024 is amended by deleting the word "and" at the end of paragraph (f), deleting the period at the end of paragraph (g) and substituting a semi-colon and the word "and" and by adding immediately after paragraph (g) the following:

             (h)  a registered psychiatric nurse licensed and acting under the Registered Nurses Act, 2008 whose licence includes the authority to prescribe under the Registered Nurses Regulations.

             (2)  Subsection 3(2) of the Act is amended by deleting the words "registered nurses" and substituting the words "registered nurses, registered psychiatric nurses". 

SNL2009 cV-6.01 Amdt.

      37. (1) Subsection 2(1) of the Vital Statistics Act, 2009 is amended by adding immediately after paragraph (q.1) the following:

         (q.2)  "registered psychiatric nurse" means a registered psychiatric nurse as defined in the Registered Nurses Act, 2008;

             (2)  Paragraph 26.1(2)(b) of the Act is amended by adding immediately after subparagraph (ii) the following:

                  (ii.1)  a registered psychiatric nurse,

NLR 24/19 Amdt.

      38. Paragraph 2(h) of the Accessible Parking Regulations under the Highway Traffic Act is repealed and the following substituted:

             (h)  "registered nurse" means a registered nurse or nurse practitioner as defined in the Registered Nurses Act, 2008.

NLR 45/15 Amdt.

      39. Paragraph 2(b) of the Access to Information and Protection of Privacy Regulations under the Access to Information and Protection of Privacy Act, 2015 is amended by deleting the words "registered nurse" and substituting the words "registered nurse, registered psychiatric nurse".

NLR 56/19 Amdt.

      40. Section 5 of the Automobile Insurance Regulations, 2019 under the Automobile Insurance Act is amended by deleting the word "and" at the end of paragraph (m), deleting the period at the end of paragraph (n) and substituting a semi-colon and the word "and" and by adding immediately after paragraph (n) the following:

             (o)  a registered psychiatric nurse as defined in the Registered Nurses Act, 2008.

NLR 83/23 Amdt.

      41. Paragraph 6(e) of the Interpersonal Violence Disclosure Protocol Regulations under the Interpersonal Violence Disclosure Protocol Act is amended by deleting the words "registered nurse" and substituting the words "registered nurse, registered psychiatric nurse or nurse practitioner".

NLR 53/18 Amdt.

      42. (1) Section 2 of the Monitored Drugs Regulations under the Prescription Monitoring Act is amended by adding immediately after paragraph (b) the following:

         (b.1)  "dispensing nurse practitioner" means a nurse practitioner licensed under the Registered Nurses Act, 2008 who dispenses monitored drugs in the course of the nurse practitioner's practice;

             (2)  Section 2 of the regulations is amended by adding immediately after paragraph (d) the following:

         (d.1)  "dispensing registered psychiatric nurse" means a registered psychiatric nurse licensed under the Registered Nurses Act, 2008 who dispenses monitored drugs in the course of the registered psychiatric nurse's employment with the Provincial Health Authority;

             (3)  Subsection 4(2) of the regulations is amended by deleting the words "physician or a dispensing registered nurse" and substituting the words "physician, dispensing registered nurse, dispensing registered psychiatric nurse or a dispensing nurse practitioner".

NLR 114/96 Amdt.

      43. Subsection 18.1(6) of the Pension Benefits Act Regulations under the Pension Benefits Act, 1997 is amended by deleting the word "and" at the end of paragraph (m), deleting the period at the end of paragraph (n) and substituting a semi-colon and the word "and" and by adding immediately after paragraph (n) the following:

             (o)  a registered psychiatric nurse as defined in the Registered Nurses Act, 2008.

NLR 15/01 Amdt.

      44. Subsection 13(1) of the Personal Care Home Regulations under the Health and Community Services Act is amended by deleting the words "registered nurse" and substituting the words "registered nurse, nurse practitioner".

NLR 121/18 Amdt.

      45. Paragraph 2(b) of the Residential Tenancies Regulations under the Residential Tenancies Act, 2018 is repealed and the following substituted:

             (b)  a registered nurse, registered psychiatric nurse or nurse practitioner registered and licensed under the Registered Nurses Act, 2008;

Commencement

      46. This Act comes into force on January 1, 2025.

ŠKing's Printer